Removal of Nasal Adhesions

Surgery Overview

Removal of nasal adhesions is a procedure to separate scar tissue
within the nose that has become connected, or fused. Fused tissue is called an
adhesion. Adhesions in the nose are also called synechiae. Adhesions are a
common, usually minor, complication of nasal or sinus surgery and nasal
packing. They also may develop because of trauma (for example, nose-picking or
cocaine use) and such conditions as
syphilis,
tuberculosis,
lupus, or
sarcoidosis.

Adhesions form when two moist, opposing surfaces inside the nose
heal together, causing a scar. They often form between the septum, which
separates the nostrils, and one of the wavy structures inside the nose
(inferior turbinate). Adhesions can make breathing difficult.

The procedure to remove adhesions usually is done in the doctor's
office under
local anesthesia. The doctor may apply an anesthetic
to the skin, using spray or cotton, and inject local anesthetic. In rare cases,
general anesthesia may be used.

The doctor may use a thin, lighted instrument (endoscope) to see into the nasal passages. He or she
may use surgical scissors, a
laser, or an instrument called a microdebrider to
separate the fused tissue. The microdebrider has a rotating tip that shaves and
removes inflamed tissue.

What to Expect After Surgery

Your nose should heal in 7 to 10 days.

After surgery, a spacer or splint may be placed in your nose for a
few days to several weeks. This helps prevent another adhesion from forming.
You should avoid blowing your nose while the spacer or splint is in place. Your
doctor will probably suggest you use an ointment, such as bacitracin/polymyxin
(for example, Polysporin), to keep your nose moist and prevent infection while
the splint is in place.

A small amount of bleeding or drainage is normal. Your doctor will tell you how to clean your nasal passages using a
saltwater (saline) solution. Sneezing is common after
nasal surgery, especially if you have allergies. You may be given an
antihistamine (one that will not make you sleepy) to reduce the sneezing. These
medicines also may reduce swelling and the likelihood that adhesions will
return.

You also may use a nasal anti-inflammatory (corticosteroid) spray. Although there is little
evidence about the use of these sprays, some doctors think they may help
prevent another adhesion from forming.

Why It Is Done

The procedure removes debris and tissue that have formed adhesions
in the nose.

How Well It Works

This procedure removes adhesions that form in the nasal
passages.

Risks

The most serious risks are heavy bleeding and infection. Call your
doctor if pus drains from your nose, because this is a sign of
infection.

Streptococcus and staphylococcus bacteria appear normally in some people.
Packing the nose after surgery in people who have these bacteria increases the
risk of
toxic shock syndrome. Call your doctor immediately if
you have any of the following symptoms:

A fever of
101°F (38.3°C) or higher

A
headache

Vomiting

Diarrhea

A rash that
looks like sunburn

Chills

Signs of very low blood
pressure, such as dizziness or fainting

There also is a risk that adhesions could return.

What to Think About

This procedure is more likely to succeed if you follow your
doctor's instructions for postsurgery care.

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